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Tuesday, 19 January 2010 18:39

pharmaceutical companies

Written by ODISHAMEDICAL.COM
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The following is a list of the twelve largest pharmaceutical companies ranked by revenue as of July 2009 in the Fortune Global 500

1 Johnson & Johnson United States

2 Pfizer United States

3 GlaxoSmithKline United Kingdom

4 Roche Switzerland

5 Sanofi-Aventis France

6 Novartis Switzerland

7 AstraZeneca United Kingdom

8 Abbott Laboratories United States

9 Merck United States

10 Wyeth United States

11 Bristol-Myers Squibb United States

12 Eli Lilly United States

The pharmaceutical industry develops, produces, and markets drugs licensed for use as medications. Pharmaceutical companies can deal in generic and/or brand medications. They are subject to a variety of laws and regulations regarding the patenting, testing and marketing of drugs.

History

The earliest drugstores date back to the Middle Ages. The first known drugstore was opened by Arabian pharmacists in Baghdad in 754, and many more soon began operating throughout the medieval Islamic world and eventually medieval Europe. By the 19th century, many of the drug stores in Europe and North America had eventually developed into larger pharmaceutical companies.

Most of today's major pharmaceutical companies were founded in the late 19th and early 20th centuries. Key discoveries of the 1920s and 1930s, such as insulin and penicillin, became mass-manufactured and distributed. Switzerland, Germany and Italy had particularly strong industries, with the UK, US, Belgium and the Netherlands following suit.

Legislation was enacted to test and approve drugs and to require appropriate labelling. Prescription and non-prescription drugs became legally distinguished from one another as the pharmaceutical industry matured. The industry got underway in earnest from the 1950s, due to the development of systematic scientific approaches, understanding of human biology (including DNA) and sophisticated manufacturing techniques.

Numerous new drugs were developed during the 1950s and mass-produced and marketed through the 1960s. These included the first oral contraceptive, "The Pill", Cortisone, blood-pressure drugs and other heart medications. MAO Inhibitors, chlorpromazine (Thorazine), Haldol (Haloperidol) and the tranquilizers ushered in the age of psychiatric medication. Valium (diazepam), discovered in 1960, was marketed from 1963 and rapidly became the most prescribed drug in history, prior to controversy over dependency and habituation.

Attempts were made to increase regulation and to limit financial links between companies and prescribing physicians, including by the relatively new U.S. Food and Drug Administration (FDA). Such calls increased in the 1960s after the thalidomide tragedy came to light, in which the use of a new tranquilizer in pregnant women caused severe birth defects. In 1964, the World Medical Association issued its Declaration of Helsinki, which set standards for clinical research and demanded that subjects give their informed consent before enrolling in an experiment. Phamaceutical companies became required to prove efficacy in clinical trials before marketing drugs.

Cancer drugs were a feature of the 1970s. From 1978, India took over as the primary center of pharmaceutical production without patent protection.

The industry remained relatively small scale until the 1970s when it began to expand at a greater rate.[citation needed] Legislation allowing for strong patents, to cover both the process of manufacture and the specific products, came in to force in most countries. By the mid-1980s, small biotechnology firms were struggling for survival, which led to the formation of mutually beneficial partnerships with large pharmaceutical companies and a host of corporate buyouts of the smaller firms. Pharmaceutical manufacturing became concentrated, with a few large companies holding a dominant position throughout the world and with a few companies producing medicines within each country.

The pharmaceutical industry entered the 1980s pressured by economics and a host of new regulations, both safety and environmental, but also transformed by new DNA chemistries and new technologies for analysis and computation.[citation needed] Drugs for heart disease and for AIDS were a feature of the 1980s, involving challenges to regulatory bodies and a faster approval process.

Managed care and Health maintenance organizations (HMOs) spread during the 1980s as part of an effort to contain rising medical costs, and the development of preventative and maintenance medications became more important. A new business atmosphere became institutionalized in the 1990s, characterized by mergers and takeovers, and by a dramatic increase in the use of contract research organizations for clinical development and even for basic R&D. The pharmaceutical industry confronted a new business climate and new regulations, born in part from dealing with world market forces and protests by activists in developing countries. Animal Rights activism was also a problem.

Marketing changed dramatically in the 1990s, partly because of a new consumerism.[citation needed] The Internet made possible the direct purchase of medicines by drug consumers and of raw materials by drug producers, transforming the nature of business. In the US, Direct-to-consumer advertising proliferated on radio and TV because of new FDA regulations in 1997 that liberalized requirements for the presentation of risks. The new antidepressants, the SSRIs, notably Fluoxetine (Prozac), rapidly became bestsellers and marketed for additional disorders.

Drug development progressed from a hit-and-miss approach to rational drug discovery in both laboratory design and natural-product surveys. Demand for nutritional supplements and so-called alternative medicines created new opportunities and increased competition in the industry. Controversies emerged around adverse effects, notably regarding Vioxx in the US, and marketing tactics. Pharmaceutical companies became increasingly accused of disease mongering or over-medicalizing personal or social problems.

 

Last modified on Tuesday, 19 January 2010 20:50
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ODISHAMEDICAL.COM

What is Telemedicine?

Here is the definition I have used over the past ten years or so to describe Telemedicine:"Telemedicine is the ability to provide interactive healthcare utilizing modern technology and telecommunications."

Basically, Telemedicine allows patients to visit with physicians live over video for immediate care or capture video/still images and patient data are stored and sent to physicians for diagnosis and follow-up treatment at a later time. Whether you live in the center of a Metro City or deep in the Remote Village, Telemedicine is an invaluable tool in Healthcare.

Here's an example of how Telemedicine works everyday. Say you have a horrible sore throat and visit your healthcare provider (could be a general practice physician, nurse practitioner, or unlicensed health worker in a village depending where you live), who does an examination and is concerned with what he sees. Your provider recommends a referral to an ENT specialist for a follow up diagnosis and treatment plan. Well, instead of traveling to the nearest specialist, which depending where you live could be anywhere from a 45-minute drive or an 18-hour ride, your provider connects you directly to the ENT specialist via Telemedicine.

Here are some of the major benefits of a Telemedicine Consultation:

The specialist actually hears your medical history and current condition directly from you and your provider instead of the specialist receiving a dictated note in the mail.

With the use of ENT medical peripherals such as a nasopharyngoscope, your provider can pass this medical peripheral into your nasal passage which will allow your provider and the ENT specialist simultaneous crystal clear video of your throat and vocal cords. The specialist may ask you to cough, pronounce letters, etc. in order to get the best outcome for the diagnosis.

The specialist can diagnose and recommend treatment immediately.

Your provider has the opportunity throughout the examination to ask questions and learn from each and every consultation. The continual education of your provider via medical consultations is an immeasurable benefit to all his patients.

Telemedicine Usage Models

Real-Time

This is the most common use in Telemedicine. Like the example above, live video allows the provider, patient and specialist to all communicate together to achieve the best outcome for the patient.

In or outpatient specialty consultation

Physician supervision of non-MD clinician

Generally require higher bandwidths (minimum 256kb)

Store and Forward (asynchronous)

Used when both health providers are not available or not required at the same time. The provider's voice or text dictation on the patient's history, current affliction including pictures and/or video, radiology images, etc., are attached for diagnosis. This record is either emailed or placed on a server for the specialist's access. The specialist then follows up with his diagnosis and treatment plan.

Teleradiology

Can be done over low or high bandwidth

Images scanned, direct capture, or digital camera

Other specialties consist of dermatology, ophthalmology, pathology

Home Health Telemedicine

When a patient is in the hospital and he is placed under general observation after a surgery or other medical procedure, the hospital is usually losing a valuable bed and the patient would rather not be there as well. Home health allows the remote observation and care of a patient. Home health equipment consists of vital signs capture, video conferencing capabilities, and patient stats can be reviewed and alarms can be set from the hospital nurse's station, depending on the specific home health device.

Usually low bandwidth analog Plain Old Telephone System (POTS). Some newer systems do support higher bandwidth capabilities.

Disease management, post-hospital care, assisted living, etc.

Summary of Benefits of Telemedicine:

To Rural Physicians and clinics (spoke sites) Receive education from the specialist/provider

Better health outcome for their patients

Enhanced community confidence in local healthcare

Attend continuing medical education courses from their clinic

To Patients

Loved ones remain in their community with family support

Cost savings from not having to travel extensively

Immediate urgent care

Confidentiality of specialty examination or visit (Because the patient visits the general practice doctor, he can be seen for any specialty care without anyone else knowing)

Patient education courses (nutrition, oncology, etc.)

Properly stabilize patient prior to transport

Early Diagnosis prior to escalated medical episode

Rural Patient's Community

Dollars follow the patient

Patients that routinely travel to visit doctors in large urban areas tend to purchase their goods and services from those cities, Telemedicine keeps those dollars local.

To Telemedicine Providers (hub sites)

Expand patient outreach

Major surgical procedures resulting from the initial telemedicine consultation

Reduction in ER visits

Promotion of Hospital

Charge tuition for clinician education courses (CME, CNE, etc.)

How can we give any hospital or clinic immediate access to a vast amount of medical experts, healthcare education/information, and support from other physicians.

How can we take all these resources and share them immediately and effectively with any hospital or clinic in the world?

We can use Telemedicine!

 

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